Ambulance trust to remain in special measures

Sussex’s ambulance trust is set to remain in special measures after the latest inspection by health regulators.

The Care Quality Commission (CQC) gave South East Coast Ambulance Service (SECAmb) an ‘inadequate’ rating in September last year after initial visits in May 2016.

NHS Improvement then placed the NHS trust in special measures to help solve problems with its urgent and emergency care, safety, and leadership.

Inspectors found that since then the trust had made some improvements in many of the areas of concern, particularly around reporting of incidents and staffing levels during busy periods.

However following this year’s inspection, SECAmb has been told to make urgent improvements in a number of areas including keeping accurate records of all 999 calls, ensuring enough clinicians are in each emergency operations centre at all times, effectively managing the computer aided dispatch system, investigating incidents in a timely manner, and keeping patient records confidential and stored securely.

Daren Mochrie, chief executive of SECAmb, said: “While I am disappointed that not enough progress has been made for us to improve our overall rating, I am confident that progress is being made and that this will continue.

“I believe that the pace of improvement has picked up since the CQC visit in May 2017 but I am very aware, as is our senior team, that there remains a significant amount of work to be done.

“Our updated improvement plan focuses on the areas where we are determined to make major improvements in the months ahead. We are working with our local commissioners to ensure that we are funded appropriately and have the right resources to meet the demand we are facing.

“Right across the trust, staff are working flat out to ensure the necessary improvements continue to be made and I am pleased that staff told inspectors that they feel more positive about the organisation and that we are heading in the right direction.”

Since the CQC inspection in May the trust has reconfigured its emergency operations centres (EOC) and created a new EOC and HQ in Crawley, as well as implementing a new computer-aided dispatch system.

Staff were found to be consistently compassionate, treating patients and callers with kindness and respect including those in mental health crisis.

Although some staff did indicate improvements in the trust’s culture and a reduction in bullying and harassment, concerns remained about the overall culture within the trust.

Richard Foster, chair of SECAmb, added: “The trust board acknowledges that not enough progress had been made since the last CQC inspection in May 2016.

“During that time there have been a number of changes at executive and at board-level and the leadership team now in place is committed to delivering the vigorous improvement programme already under way.”

CQC has also inspected the NHS 111 service provided by the trust which has been rated as ‘good’.

Ted Baker, the CQC’s chief inspector of hospitals, said: “Although we have seen some areas of improvement, South East Coast Ambulance NHS Foundation Trust has not yet made enough progress for me to recommend that it should leave special measures.

“I am concerned that the previous leadership had not fully addressed longstanding cultural issues and in particular the historical problems of bullying and harassment. While the problem is now being addressed there is still work to be done here and in the management of medicines.

“It is clear there have been deep rooted problems and the trust would now benefit from a period of stable management to address these issues. I am aware that there has been a recent appointment of a new chief executive who has considerable experience within the ambulance service and should bring that renewed stability.

“The board have assured us that they are focussed in supporting the chief executive to carry the improvements that are needed.

“In the circumstances however, I have advised NHS Improvement that the trust should continue to receive the additional oversight and support provided by special measures until such time we can report on significant and sustained improvement.”

Nigel Sweet, who works as an ambulance technician at SECAmb but speaking as a UNISON steward, explained that staff were keen to work constructively with the trust’s management and board to accelerate improvements already underway.

He said: “There is an improved mood. I can’t pretend that morale is good but I’m convinced we have bottomed out and we are improving.”

Changes instituted by the board have meant staff are receiving guaranteed meal breaks at the appropriate time and are finishing shifts on time.

He also welcomed the improvements made to NHS 111, and described how ‘it’s good from the trust’s point of view that we have got one part of the system that is now rates as good’.

He added: “We have got a good gauge on how to do it and now we need to spread that good practice across the trust.”